1. Field of the Invention
This invention relates broadly to eye bandages. More particularly, this invention relates to a post-operative eyelid splint which maintains the upper lid in a closed position.
2. State of the Art
Frequently after eye surgery or eye injury, the upper lid must be maintained in a closed position over the eye. A closed upper lid aids healing following corneal or cataract surgery. In addition, recovery from conditions such as corneal abrasions, corneal ulcers, corneal burns, and keratitis is helped from the constant protection offered by fixing the upper and lower lids relative to each other, i.e., in a closed position.
One method of immobilizing the eyelids is tarsorrhaphy; that is, suturing the upper and lower eyelids closed. The method is very effective. However, it requires surgery which is painful, expensive, and time consuming. The procedure can also cause scaring at the eyelid margins. Moreover, tarsorrhaphies are cosmetically undesirable.
Another method of protecting the cornea, but which does not immobilize the lids, is the use of a bandage contact lens. Bandage contact lenses easily fit between the eyelids and the cornea. In addition, they are cosmetically acceptable, are relatively inexpensive, and can easily be removed. However, bandage contact lenses often fall out of eyes without patient knowledge and are also prone to causing corneal infections. The fear of infection limits their use to occasional use and only by ophthalmologists. Moreover, the use of bandage contact lenses is limited to particular applications in which it is permissible for the eyelids to move over the cornea and sclera.
The most common method of eyelid immobilization is carried out by placing pressure with a bandage against the upper and lower lids to maintain the upper and lower lids in a closed position. This is most typically done by placing cotton pads over a closed upper lid, and tightly wrapping tape around the cotton pads and the head of the patient to place pressure on, and thereby immobilize, the lid. However, the tight pressure placed by the bandage on the eye can cause discomfort to the patient. As a result, the patient often prematurely removes the bandage, thereby irritating and potentially causing harm to the eye. In addition, a bandage of cotton pads and tape can be very bulky (preventing the use of eyeglasses for the non-bandaged eye) and is also unsightly. Furthermore, each time access to the eye is required, e.g., for examination by a physician or for administration of a medication, the complete bandage must be removed and discarded, and a new bandage must be then be applied. In removing the tape of the bandage from the face, the facial skin is often irritated or abraded.
Because of these problems a number of other eyelid immobilization products have been proposed. For example, U.S. Pat. No. 4,134,401 to Galician discloses an eye patching system which includes a narrow adhesive strip and other optional components. The adhesive strip is provided across the upper and lower lids (i.e., perpendicular to the juncture of the upper and lower lids) to hold the lids together and, thus, immobile. A strip of absorbent material, potentially carrying medicine, may be coupled on one side to a large piece of tape, and the piece of tape may be adhered to the upper and lower lids such that the strip of absorbent material is positioned lengthwise along the juncture of the upper lids. The absorbent material is thus able to supply medicine through the juncture. A gauze sponge may also be applied to the tape between the tape and the absorbent material. The narrow adhesive strip and tape assembly are separate components, applied separately, which presumably work in conjunction with each other. While the Galician device is not nearly as bulky as conventional eye bandages, proper alignment of the separate components requires a high degree of skill. It will be appreciated that the small and narrow adhesive strip must be aligned generally vertically while the strip of absorbent material must be aligned generally horizontally. Moreover, examination of the eye and the administration of medicine (other than that already located on the absorbent strip) requires removal of at least a portion of the bandage.
U.S. Pat. No. 4,677,974 to Leonardi describes another bandage device formed of a foam member coupled to a rigid backing. Rather than using an adhesive to hold the bandage against the eye, the device utilizes two elastic straps having hook and loop fastening means, with each of the elastic straps being coupled to opposite ends of the backing. The foam member is placed against the upper and lower lids and the straps are fastened around the back of the head of a patient. While the bandage device may be applied and removed rather easily, it nevertheless immobilizes the eyelid using pressure, which can cause discomfort to the patient. In addition, the device is rather conspicuous and may cause a patient to be self-conscious about wearing the bandage, potentially to the point of causing the patient to remove the device.
U.S. Pat. Nos. 5,180,360 and 5,389,066 to Rhame, Jr., describe yet another bandage device which includes a foam or inflatable bladder portion which maintains the eyelid in a closed position. A large oval or rectangular adhesive patch, which adheres to the skin around the eye, holds the foam or bladder portion in position against the upper lid. Like other prior art bandages, the device uses pressure against the upper lid to keep the lid closed and the device must be removed to examine or administer medication to the eye.
A more recent method for maintaining the upper eyelid in a closed position uses serrated, transparent, adhesive tape, which is torn into a one-inch by one-inch piece and firmly pressed onto the lid. The tape splints the lid (i.e., stiffens the lid), preventing the lid from being opened when such is attempted by a patient. However, as the tape is relatively thin and transparent, and because the tape has been firmly pressed to the lid, removal of the tape from the lid is difficult. Furthermore, because the torn pieces of tape are rectangular in shape, by nature of the serrations, the tape pieces are not ideally suited to the shape of the upper eyelid which is more oval in shape. Moreover, the adhesive of the tape is relatively weak, causing unintentional detachment of the tape from the lid in approximately twelve to twenty-four hours.